There is growing evidence that there is a relationship between major depressive disorder (MDD), also simply known as "depression", and inflammatory processes. Selective serotonin inhibitors, such as fluoxetine, are used as a first-line treatment for depression, and it is hypothesized that its use can reduce levels of proinflammatory cytokines. The aim of this systematic review and meta-analysis is to enable a better understanding of how treatment with the antidepressant fluoxetine modulates inflammation, and the roles of the main cytokines in this process. Risk of bias (RoB) in the included studies was assessed using the Cochrane Risk of Bias Assessment tool for Non-randomized studies (RoBANS). In the meta-analysis, standardized mean difference (SMD) was used as a summary statistic and grouped statistics using the generic inverse variation method in RevMan 5 with random effects model. Heterogeneous changes in cytokine levels were also evaluated from the SMD forest plot of individual studies. After analysis, we observed that fluoxetine was able to decrease TNF-α levels (SMD ± 0.90, 95% CI = 0.16, 1.165, Z ± 2.40, p = 0.02), but not change IL-6 levels (SMD ± 0.37, 95% CI = 0.21, 0.95, Z ± 1.25, p = 0.21).Fluoxetine acts by modulating neuroimmunology, and not only by acting only on the independent restoration of neurotransmission and neuroinflammation pathways.

中文翻译：

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抑郁症患者使用氟西汀的炎症调节：系统评价和荟萃分析

越来越多的证据表明，重度抑郁症 (MDD)（也简称为“抑郁症”）与炎症过程之间存在关联。选择性血清素抑制剂，如氟西汀，被用作抑郁症的一线治疗药物，据推测，它的使用可以降低促炎细胞因子的水平。本系统评价和荟萃分析的目的是更好地了解抗抑郁药氟西汀治疗如何调节炎症，以及主要细胞因子在这一过程中的作用。纳入研究中的偏倚风险 (RoB) 使用 Cochrane 非随机研究偏倚风险评估工具 (RoBANS) 进行评估。在荟萃分析中，标准化平均差 (SMD) 用作汇总统计量，并使用 RevMan 5 中的通用逆变异方法和随机效应模型进行分组统计量。还从单个研究的 SMD 森林图中评估了细胞因子水平的异质变化。分析后，我们观察到氟西汀能够降低 TNF-α 水平（SMD ± 0.90, 95% CI = 0.16, 1.165, Z ± 2.40, p = 0.02），但不能改变 IL-6 水平（SMD ± 0.37, 95 % CI = 0.21, 0.95, Z ± 1.25, p = 0.21。 氟西汀通过调节神经免疫学起作用，而不仅仅是通过仅作用于神经传递和神经炎症通路的独立恢复。